Long-Term Care Provisions Would Be Repealed in Fiscal Cliff Bill

The bill to avert the fiscal cliff would repeal a suspended program in the 2010 health care law that has long been targeted by Republicans.

The Department of Health and Human Services suspended implementation of the long-term care insurance program in October 2011, but Republicans still have pushed for full repeal. Most Democrats resisted, saying the program needed to remain on the books so it could be improved and replaced.

But the fiscal cliff bill (HR 8) would fully repeal the Community Living Assistance Services and Supports (CLASS) Act and put a commission on long-term care in its place. Including the provision is a victory for Republicans, who have been concerned that the administration could bring the program back in a form they would oppose.

The Senate passed the measure, 89-8, early Tuesday. House plans for a vote on the bill remain unclear.

The Congressional Budget Office originally scored the CLASS Act as saving $70.2 billion over 10 years. After the administration suspended the program, however, the CBO said it would score a straight repeal as costing nothing.

The commission, made up of 15 appointed members, would be tasked with developing a plan to establish, implement and finance a comprehensive system for long-term care. If a majority of the members vote in favor of a plan, the group’s recommendations would be sent to Congress. A summary of the bill said the commission provision “has no scoring implications.”

In February, the House passed a bill (HR 1173) to repeal the CLASS Act, with the support of 28 Democrats. In August, bill sponsor Rep. Charles Boustany Jr., R-La., and Sen. John Thune, R-S.D., wrote to HHS saying they were concerned that administration officials were meeting with stakeholders to discuss reviving the program in some form. Thune is the sponsor of a similar repeal bill (S 720).

“The Senate’s action will ensure that the CLASS Act, which the president’s own HHS secretary has called ‘totally unsustainable,’ will be permanently removed from law so that it can never be implemented,” Thune said in a written statement. “The House of Representatives has already voted to repeal this fiscally insolvent new entitlement, and I look forward to the House considering repeal again.”

Without formal repeal, the Republicans have argued, HHS could be in violation of the law’s requirement to designate a benefit plan for the program by October 2012.

The CLASS Act, created in the 2010 health care law (PL 111-148, PL 111-152), was designed to allow workers to pay into a fund that would provide a $50 daily cash benefit for long-term care services. The program was structured to collect premiums for five years before it began paying out benefits, which helped CBO score it as a 10-year savings. Republicans argued that that amounted to a budget trick.

HHS suspended implementation of the program in October 2011 after determining that it could not meet requirements set out in the law that it be voluntary, self-sustaining, and solvent for 75 years.